Current Controversies and Challenges in Non-Oncogene-Addicted Synchronous Oligometastatic Non-Small Cell Lung Cancer: A Review.

This statement is challenged by the results of the NRG-LU002 randomized phase 2/3 trial, showing no significant progression-free survivaland overall survivalimprovements with the addition of LRT to maintenance systemic therapy in patients with oligometastatic non-small cell lung cancer (NSCLC) who achieved at least stable disease after induction systemic therapy (approximately 90% received an immunotherapy-based regimen).

这一观点受到了NRG-LU002随机2/3期试验结果的挑战，该试验显示，在接受诱导系统治疗后至少达到疾病稳定状态的寡转移性非小细胞肺癌（NSCLC）患者中，加入LRT到维持性系统治疗并未显著改善无进展生存期和总生存期（约90%的患者接受了基于免疫治疗的方案）。

This Review discusses the current challenges and controversies in the treatment of non-oncogene-addicted sOMD.

本综述讨论了在治疗非致癌基因依赖性sOMD时当前面临的挑战和争议。

observations

Whether LRT indeed can improve survival in a contemporary immunotherapy-based systemic treatment regimen is discussed as well as the optimal treatment sequence.

同时，本文还探讨了局部放射治疗(LRT)是否真的能在以现代免疫治疗为基础的全身治疗方案中改善生存率，以及最佳的治疗顺序。

Moreover, the NRG-LU002 trial also sparks debate of whether a true sOMD state exists.

此外，NRG-LU002试验也引发了关于是否存在真正的sOMD状态的辩论。

Genomic alterations, the tumor microenvironment of the primary tumor and metastasis, organotropism, and tumor heterogeneity can all influence metastatic potential, giving a biological explanation that there could be existence of a true sOMD state.

基因组改变、原发肿瘤和转移的肿瘤微环境、器官亲和性以及肿瘤异质性都可以影响转移潜力，这为可能存在真正的sOMD状态提供了生物学解释。

However, as true sOMD cannot be distinguished from early-detected widespread metastatic disease with the current imaging modalities, it becomes difficult to select patients for a radical strategy and protect patients from futile treatment.

然而，由于当前的影像学手段无法区分真正的寡转移性疾病（sOMD）和早期发现的广泛转移性疾病，因此很难选择患者进行根治性策略，并保护患者免受无效治疗。

conclusions_and_relevance

It remains under debate whether synchronous oligometastatic NSCLC represents a distinct biological entity or merely a probabilistic imaging finding.

是否同时性寡转移性非小细胞肺癌（NSCLC）代表一个独特的生物学实体，还是仅仅是一个概率性的影像学发现，这仍是一个争论的问题。

Biomarkers such as circulating tumor DNA, microRNA, and radiomics may improve patient selection but require further validation.

循环肿瘤 DNA、微 RNA 和放射组学等生物标志物可能改善患者选择，但需要进一步验证。

Clinical trials should prioritize translational research to address these challenges.

临床试验应优先考虑转化研究以解决这些挑战。